A rare focal atrial tachycardia arising from the proximal middle cardiac vein: a case report

• Published in: BMC cardiovascular disorders 2023-03, Vol.23 (1), p.169-169, Article 169
• Main Authors: Guo, Min, Zhang, Nan, Jia, Gao, Ma, Guijin, Li, Xin, Wang, Rui
• Format: Article
• Language: English
• Subjects: Ablation; Adenosine; Adrenergic beta blockers; Adult; Analysis; Cardiac arrhythmia; Case Report; Case reports; Catheter ablation; Catheter Ablation - methods; Catheters; Coronary Sinus - diagnostic imaging; Coronary Sinus - surgery; Diagnosis; Dosage and administration; Drug therapy; Echocardiography; EKG; Electrocardiogram; Electrocardiography; Electrophysiological recording; Female; Focal atrial tachycardia; Heart Atria; Heart diseases; Humans; Medical imaging; Morphology; Paroxysmal tachycardia; Patient outcomes; Patients; Proximal middle cardiac vein; Radiofrequency ablation; Tachycardia; Tachycardia, Paroxysmal; Tachycardia, Supraventricular - diagnosis; Tachycardia, Supraventricular - surgery; Veins & arteries; Young Adult
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-023-03172-4

Focal atrial tachycardia (FAT) always originates from atrium specific sites and can be successfully cured by radiofrequency (RF) ablation. However, the middle cardiac vein (MCV) is a rare site of focal atrial tachycardia. Herein, we present a case of a 20-year-old young woman with FAT. Electrophysiological examination showed FAT arising from the proximal middle cardiac vein (pMCV), and successful RF ablation was applied with a low power and short-ablation. A 20-year-old woman with no structural heart disease suffered recurrent supraventricular tachycardia for 1 year. Physical examination, laboratory studies and the echocardiography results of this patient were normal. A 12-lead electrocardiogram (ECG) showed a narrow QRS and long RP tachycardia which was always triggered by a sinus rhythm. The patient underwent an electrophysiological study and found the earliest activation was in the proximal MCV (pMCV). After a low power and short-ablation, AT was terminated and noninducible by programmed pacing with or without isoproterenol infusion. This case presented a rare case of FAT arising from the pMCV. We demonstrate that low power and short-ablation are effective in AT arising from specific areas such as the coronary sinus ostium and pMCV.